Ophthalmology in China ›› 2014, Vol. 23 ›› Issue (1): 13-18.doi: 10.13281/j.cnki.issn.1004-4469.2014.01.005

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The preliminary study on effectiveness and safety of trabectome surgery for open angle glaucoma

WANG  Huai-Zhou, SHI  Yan, HONG  Jie, ZHAO  Bo-Wen, WANG  Ning-Li   

  1. Beijing Institute of Ophthalmology; Beijing Ophthalmology & Visual Sciences Key Lab.; Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing 100005, China
  • Received:2013-12-11 Online:2014-01-25 Published:2014-01-22
  • Contact: WANG Ning-li, Email: wningli@vip.163.com

Abstract: Objective To evaluate the effectiveness and safety of trabectome surgery (trabeculectomy-internal approach ) in patients with open angle glaucoma. Design Prospective non-comparative case series. Participants 12 eyes of 11 patients with primary open angle glaucoma(POAG), 1 eye with congenital glaucoma and 2 eyes of 2 patients with developmental glaucoma were recruited. Methods Trabectome(NeoMedix Corp.) was inserted to the viscoelastic installed anterior chamber through a 1.7 mm keratome near-limbal temperal corneal incision under operating microscope. The instrument electroablated the meshwork and inner wall of Schlemm’s canal for 120 degree under direct view assisted by goniolens. 2 cases had the Trabectome-phacoemulsification surgeries. The postoperative follow-up period ranged from 3 weeks to 12 months. Success was defined as intraocular pressure (IOP) ≤21 mmHg or ≥20% IOP reduction with or without medications and no secondary glaucoma surgery.  Main Outcome Measures IOP, numbers of adjunctive medications and intraoperative and postoperative complications. Results 53.3% patients finished 3 months follow-up and 20.0% further followed up for one year. Preoperative IOP averaged 27.57±9.46 mmHg in these 15 eyes, mean preoperative number of antiglaucoma medications were 2.27±0.88. Mean postoperative IOP was 20.07±7.86 mmHg and decreased by 17.3%. Postoperative medications reduced to 1.15±1.04. Seven (46.7%) cases achieved the criteria of success at the last visit. Intraoperative blood reflux had occurred in all eyes at instrument removal. Postoperative hyphema at 1 day was noted in 10 of the 15 patients (67.7%) with clearing by a mean of 5.4±3.1 days. Vision decrease of 2 lines or more occurred in 3 of these 10 patients and vision returned to preoperative levels in all patients after spontaneous clearing of hyphema. Gonioscopy revealed focal goniosynechiae in the areas ablated through the follow-up period in 4 eyes (26.7%). Conclusions This small sample and short follow-up period study demonstrated that trabectome surgery is an effective and safe surgery to treat open angle glaucoma. (Ophthalmol CHN, 2014, 23: 13-18)

Key words:  trabeculectomy-internal approach, open angle glaucoma/surgery